Antihypertensive drug therapy and hypoglycemia in elderly diabetic patients treated with insulin and/or sulfonylureas

We performed this case-control study to evaluate the risk of hypoglycemia a ssociated with the use of antihypertensive drugs in older hospitalized diab etic patients treated with sulfonylureas and/or insulin. All diabetic patie nts admitted during 4 months in 1988, 1 month in 1991, 4 months in 1993 and 4 months in 1995 (n = 3477, mean age 71.4 +/- 0.2 years, 1542 males and 19 35 females) were enrolled in the study. During the four annual surveys 86 p atients (mean age 71.1 +/- 1.4 years, 33 males and 53 females) presented hy poglycemia during hospital stay. The patients who presented hypoglycemia we re less frequently users of sulfonylureas and more frequently users of a co mbination of insulin and sulfonylureas. Use of antihypertensive drugs was s imilar in the two groups studied, and among potentially interacting drugs c onsidered in the analysis, sulfonamides were more frequently used in patien ts who experienced hypoglycemia. Moreover, patients with hypoglycemia used a higher number of drugs, had a longer length of stay and had a greater pre valence of hypoglycemia as admission problem. Finally, although not signifi cant, liver and renal diseases were more frequent among patients with hypog lycemia. In the multivariate analysis, contemporary use of insulin and sulf onylureas, liver disease and length of stay were significantly associated w ith hypoglycemia, while none of the antihypertensive drugs showed a signifi cant association with the occurrence of hypoglycemia during hospital stay. Our results indicate that antihypertensive drugs do not increase the risk o f hypoglycemia in elderly diabetic patients.